Spontaneous Coronary Artery Dissection

SCAD journey event in my own words/view/feelings

July 20, 2014

SCAD journey event in my own words/view/feelings:
Date Wednesday July 31st 2013
The day began the same as every other day. I was not stressed at all, but I did feel tired and sad. I got up at 6:30 am had my coffee, breakfast and then showered and went off to work. I work for municipal government in the finance department doing the payroll/ HR. I will explain why I felt tired and sad. I had just gotten back for New York City, where on July 25th was my son’s wedding. So there were many events which I had attended so there was a full week of activities. One of the events being trapeze school, in which even though I was 57 years old I was in good shape I, had participated in. The reason why I am telling you this is to show you I had no physical limitations or underlying illness and was over all in good shape being 5’7” @ 135 lbs. The reason why I was feeling sad was after the weeklong events, my son and his wife were returning to where they live in Australia and I was worried that I would not be able to see them for some time. So, I just missed my son, this was why I felt sad.  In 2013 I had just started menopause at the age of 57, and was told that I had started later than normal age of 50ish. I was getting many hot flashes through the day and night for months, but I was not on any HRT.

Looking back, I now realize the SCAD event started just after my lunch on Wednesday July 31st 2013. When I returned to my desk after lunch my upper chest felt tight and sore and my left side of my neck hurt. The tightness began to get more painful I would say about 5 out of 10, and my left side of my neck was tight and distended and just plain hurt. I did get a little worried and then just thought I must have eaten something bad at lunch time, never really thinking about my heart. So I just stayed in my office area and closed the door, within a short period of time the pain lessened to just a discomfort. At that time I just started to work again and just thought again I had eaten something bad. At 4:30pm I went home from work. On the drive home the chest started again to feel discomfort, but again I ignored it and just continued doing my normal activities. I did not mention anything to my husband, and sent him off sailing that evening. At supper time I was alone was just about to eat when the pain across my upper chest and my left side of my neck felt like it was about to explode. The pain was 10 out 10, I could not move other than just lay and roll on the couch. My cats new something was wrong they would not stop howling beside me. I thought I should get to the phone and call 911, but then since I pay the Fire Fighters they would know me and I was embarrassed …a very stupid silly thought I know…I was not thinking rationally for sure. This horrible pain continued for about an hour, once I was able to stand I went to the bathroom and vomited. I looked in the mirror and looked awful and botchy all over. The pain was not gone, but it was less that I was able to walk. After vomiting I thought I need to get to the hospital, something was wrong with me. What I did next was very bad, that I drove myself to the hospital. I literally dragged myself to the hospital. Once I arrived into the emergence department I was taken within 5 minutes and hooked up to the monitors. I again told the nurse I must have eaten something that was bad, I would not believe anything was happening with my heart. In less than an hour it appeared I had a heart attack. No one would believe me that I did not have any underlying illness that would have caused this. The one doctor kept telling me I must be a smoker, and would not believe me that I had never smoked a day in my life. The staff dispensed different medications and needles, and admitted me to ICU. I then told them I feel better and the pain again was just a discomfort, so can I go home. Of course they did not discharge me. Looking back I was still in denial.

I would not let my husband tell my son about the heart attack, because they were on their honeymoon and I did not want to ruin anything for their special time together. At one point a doctor said to me, you do realize we are treating for a heart attack, again my denial was the dominate emotion. But when I was alone in the middle of the night I did start to cry not understanding why this was happening to me. Since all my life I tried to eat right, exercise and stay relatively fit. Nothing made any sense to me. Even when my husband had contacted my place of employment no one at work could believe this happened to me and they were also all in shock.
The next day I was transferred via ambulance to another hospital to have an angiogram and cauterization to see what had happened. When I arrived in the cardiac unit and looked around I was surrounded by all these very elderly clients that I grabbed the doctor’s arm and said this is not happening to me I am too young and not ill. All he did was smile at me. During all this I was having low grade chest pain on my lower help side of my chest. I had the procedure and at that point the doctor informed me …yes you are too young for a heart attack, and what I had was a spontaneous cardiac arterial dissection and the location was at the apex of the heart, and this caused the heart attack and the damage is so minimal at the apex of the heart. He stated it should heal on its own, and should never happen again, and I would be treated medically and once healed I should not feel anything at all.

Looking back I should have asked more questions, but I was so doped up and had trouble understanding him. When they transferred me back to the first hospital the attending physician said to me …Oh never had anyone who had a SCAD, and the another doctor said oh it is rare do not know really how to treat it. I had no confidence in anyone to help me. I felt scared and frustrated. The next day I was released from the  hospital with my new medication. And my life had changed forever.

I had never been on medication so this was very new to me totally. I also felt I had no direction to follow. I just wanted me to come back to the way I was before this event happened. The medication I am on is clopidogrel , aspirin, and metoprolol. I was told I would have to be on them for one year. At the last check up the cardiologist, would like me to stay on the metoprolol for 6 months longer pass my one year anniversary date of July 31st. The dosage is now lowered to 12.5 mg bid, since I never had high BP to start off with. I will be glad to be off the medication totally if and when it happens.

In the couple months that followed I felt weak, tired, had shortness of breath and had constant low grade chest/shoulder, neck, and jaw pain for months in various degrees. I went back to emergency department on day in September 2013 because the pain would not let up that day; I was so frustrated and upset with the experience in the emergency department because the nurse said I must have pulled a muscle and the doctor did not even look at me. My answer to them was you have not even read my history that just a month ago I had a heart attack due to SCAD. At that point I walked out. I do not look like I should have had a heart attack, so hence the staffs form an opinion with my appearance alone. Plus, some (or most) have no idea what SCAD is.

I had the echogram, and everything appears to be good. I have had the stress tests and again it appears to be moderate. I need answers; emotionally it can be very depressing not knowing. I searched the web for answers; I also joined the SCAD face book group. I was (still am) desperate to get information to understand. I am now part of the research study on SCAD at the Mayo clinic.
It did help to read that I was not alone, and what I am feeling both physically and emotionally I was not alone and nor was I crazy…this really did all happen, and I needed to move forward. It has been 11 months now, and I am starting to feel more like myself. But there is still some shortness of breath, not much but it does show up every once in a while. I am the same but different now, that I know 100% it is the new me.

Is this in my head or is it real…these are the thoughts that goes through my mine at times. The cardiologist that I see now really does not say anything at all, I feel frustrated. I ask how I would I know if it is totally healed …I get no really answers. Do I fear another SCAD, the answer is totally yes. And maybe I will not be so lucky the next time. For I was lucky, my SCAD event was located at the apex of the heart, it could have been a lot worst. So being accepted into the study group makes me feel I am being proactive that it just may help me understand more and hopefully help others in the future.